Provider Demographics
NPI:1124257829
Name:DR JOHNNIE LYNN HUNT LLC
Entity type:Organization
Organization Name:DR JOHNNIE LYNN HUNT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LLC
Authorized Official - Phone:225-769-1969
Mailing Address - Street 1:9804 BLUEBONNET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6442
Mailing Address - Country:US
Mailing Address - Phone:226-769-1969
Mailing Address - Fax:225-796-1970
Practice Address - Street 1:9804 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6442
Practice Address - Country:US
Practice Address - Phone:226-769-1969
Practice Address - Fax:225-796-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty